Pediatric TPN: efficacy and toxicity of a new fat emulsion

Abstract

Fat emulsions are particularly valuable in pediatric total parenteral nutrition (TPN) because they provide an isotonic solution rich in calories. Little is known about the ideal composition of fatty acid emulsions, however, and very few formulations are commercially available. A new fat emulsion using a safflower oil base has recently been approved. We have used this new emulsion to provide a significant percentage of the nonprotein caloric requirements (24 to 42%) in 4 patients requiring TPN. These patients ranged in age from 1 to 15 years and received no enteral nutrition during the 3-week course of the study. Nutritional improvement without major toxic effects was documented in each patient.

Effects of lipid administration on liver apoptotic signals in a mouse model of total parenteral nutrition (TPN)

“…It is known that the role of Bcl-xl is that of an anti-inflammatory mediator in macrophages and immature CD4+CD8+ thymocytes [24,25]. In our model, the Bcl-xl expression might correlate with increasing macrophage activity after the administration of lipids in TPN models, because the lipid emulsion is known to lead to the suppression of immunologic function [1,2,3,4,5]. Further investigation of this problem is warranted.…”

“…Clinically, fat-free TPN may rapidly lead to essential fatty acid deficiency. [1,2,3,4,5]. Therefore, parenteral administration of essential phospholipids, via lipid emulsions, is critical [6].…”